Individual provider Active NPI

Terry Wayne Sherraden, M.D.

  • Specialist
  • Tallahassee, FL
National Provider Identifier
1629003207
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0045932 Issued in FL
Practice address
2406 E Plaza Dr
Tallahassee, FL 32308-5301
Phone
(850) 877-7387
Fax
(850) 656-3376
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0045932 FL Primary

Addresses

Primary practice location

2406 E Plaza Dr
Tallahassee, FL 32308-5301

Mailing address

2633 Centennial Blvd
Suite 100
Tallahassee, FL 32308-0585
Phone (850) 877-7387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0045932FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc CurrentSince Aug 1, 2012 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Aug 1, 2012 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Tallahassee Endocrine Associates Specialist PastSince Oct 1, 1991 Accepting new patients

Locations

1309 Thomasville Rd
Tallahassee, FL 32303
Phone (850) 431-5910

2633 Centennial Blvd
Tallahassee, FL 32308
Phone (850) 877-7387

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

2633 Centennial Blvd
Ste 100
Tallahassee, FL 32308
Phone (850) 431-5404

1300 Miccosukee Rd
Tallahassee, FL 32308
Phone (850) 431-1155

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1629003207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 CENTENNIAL BLVD",
            "address_2": "SUITE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080585",
            "telephone_number": "850-877-7387",
            "fax_number": "850-656-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 E PLAZA DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085301",
            "telephone_number": "850-877-7387",
            "fax_number": "850-656-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRADEN",
        "first_name": "TERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0045932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.